On Feb 22, 2021, the UK Government announced that schools in England would fully reopen on March 8, 2021. While returning to school as soon as possible is imperative for the education, social development, and mental and physical welfare of children, not enough has been done to make schools safer for students and staff.
Primary and secondary school closures have been associated with substantial reductions over time in the effective reproduction number (Rt) across many countries (including England) and time periods.
In contrast, data from the Office for National Statistics’ (ONS) 2020 COVID-19 Infection Survey show that the prevalence of infection among children aged 2–10 years (2%) and 11–16 years (3%) rose above the prevalence for all other age groups before the 2020 Christmas break.
Both modelling and real-world data in preprint showing rising cases in regions where the SARS-CoV-2 B.1.1.7 variant was prevalent during the lockdown in November, 2020 (when schools were open), suggest that opening all schools now without robust mitigatory measures in place will probably lead to Rt rising above 1 in almost all scenarios. Modelling data by the University of Warwick and Imperial College London suggest that at least 30 000 more deaths from COVID-19 are estimated under the proposed reopening scenarios.
Throughout February, 2021, despite fewer students being in school at this time, teaching staff were at higher risk of infection. Recent school outbreaks in northern Italy, where the B.1.1.7 variant is prevalent, are also concerning. Although COVID-19 is unlikely to cause severe disease in children, estimates of the prevalence of long COVID symptoms based on the ONS Infection Survey suggest that 13% of children aged 2–10 year and 15% of those aged 12–16 years have at least one persistent symptom 5 weeks after testing positive. Given uncertainty around the long-term health effects of SARS-CoV-2 infection, it would be unwise to let the virus circulate in children, with consequent risk to their families. Reopening fully in the setting of high community transmission without appropriate safeguards risks depriving many children of education and social interaction again, worsening existing inequalities. By contributing to high community transmission, it also provides fertile ground for virus evolution and new variants.
Multi-layered mitigations can substantially reduce the risk of transmission within schools and into households. In the table it’s summarised a set of recommendations that are in line with guidelines from the US Centers for Disease Control and Prevention (CDC) and practised in many countries to reduce the risk of transmission in schools and mitigate the impact of COVID-19 on children and families. Making schools safer goes hand in hand with reducing community transmission and is essential to allow schools to safely reopen and remain open.
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